Complete information on the methods of birth control in human beings

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Complete information on the methods of birth control in human beings

1. Control of sexual intercourse

a. Withdrawal method:

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Here the male organ is withdrawn from the vagina just before the discharge of the semen. This however is not only foolproof but may lead to psychi disturbances.

b. Rhythm method (for females):

This method depends on the avoiding of intercourse (and non availablility of sperms) during the fertile period (ovu­lation period). In this method where the normal menstrual cycle is of 28 days, ovulation occurs on the 14th day starting from the beginning of the menstrual period. Since the ovum can be fertilized only when it is travel­ling in the fallopian tube it will be comparatively safe to hafted intercourse a week after the period and a week before the period.

The middle 10 days can be regarded as fertile period when conception can take place. Rhythm method is a natural method as it does not involve any artificial devices. However it is not 100% fool proof as the menstrual cycle may vary in women. As the cycle is under hormonal control, stress, strain and other psychological factors may alter the duration. Hence it is difficult to calculate the safe period.

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c. Rhythm method based on body temperature:

In this method women have to monitor their body temperature daily. The body temperature falls before ovulation and rises after ovulation. Women have to avoid inter­course from 5th day after menstruation is over to until 3 days after the temperature has risen. The body temperature is recorded using a special thermometer.

Another variation of the temperature method is to avoid intercourse every month until 3 days after the rise in body temperature. The disadvantages in this method are body temperature has to be carefully measured every day and it may not be totally safe.

2. Mechanical barriers to prevent the entry of sperms

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a. Condom:

This is of three types – latex rubber, membrane (skin) and rubber cap (American type). The latex rubber type is available in several brand names and is a rubber sheath. It is rolled over and has to be put over the male sex organ in order to prevent the entry of sperms during inter­course. Some condoms have a teat at the tip to allow for the collection of the sperms.

In addition to physically preventing the sperms from entering the uterus, condom also gives protection to the individual from contacting communicable diseases such as syphilis, gonorrhoea and AIDS.

b. Diaphragm:

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It is a shallow cup of thin rubber stretched over a flexible ring. This is inserted into the vagina and placed at the mouth of the cerivx. Initially it requires the help of a doctor to place the diaphragm in proper position. Additionally the diaphragm may be coated with spermicidal jelly for extra safety. The diaphragm is to be removed after every intercourse.

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3. Chemicals methods

These include a number of methods such as – a. Douching, b. Sponges, tampoons and foram tablets, c. Spermicidial jelly and d. Oral contracep­tives.

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a. Douching:

This refers to washing the vaginal canal immediately after the intercourse with fluids such as salt water, lime juice, detergent water etc. A douching nozzle is to be used for this purpose.

b. Spermidicial jelly:

Contraceptive jelly is to be smeard all over the inte­rior of the vagina as deep as possible. For this purpose special applicators are available.

Foam tablets or pessaries which are to be kept in vagina before the inter­course dissolve and form spermicidial foam. A number of brands of spermicidial pessaries are available in the market.

4. Intra uterine contraceptive device (IUD)

These are devices that are placed inside the uterus. The basic principle behind the use of IUD is that any foreign material placed inside the uterus prevents the implantation of fertilized ovum. Common IUDs are – loop and copper ‘T’.

A. Loop:

This consists of a polythene ‘S’ shaped loop with an attached string and can be is inserted into the uterus with the help of a plunger (insertion device). An experienced gynaceologist only can do this. When once inside the uterus the loop uncoils. The string is necessary to pull out the loop when it is not necessary (i.e., when conception is needed). Loop has merits as well as some demerits. While it is 100% fool proof, it may cause pain or increase menstrual flow.

B. Copper T:

This is just like loop, but’T’ shape and emits small quan­tities of copper which acts as a spermicide. This has to be inserted into the uterus with the help of a gynaecologist.

5. Surgical methods

a. Vasectomy (in men):

Vasectomy refers to cutting and rejoining the vas deferens through which the sperms move. As a result, a block is created and sperms do not reach urethra even though semen s produced. Vasec­tomy is a minor surgical procedure for men does not require hospitaliza­tion.

b. Tubectomy (in women):

In this method which is a surgical procedure requiring general anesthesia, the abdomen of the woman is opened and the fallopian tubes of both ovaries are cut and legated (tied) again. This pre­vents the movement of the ovum beyond the tied end of the fallopian tube. As tubectomy requires hospitalization, it is best done after delivery when the women will be in hospital any way. Tubectomy should not be done on pregnant women.

Sterilization surgery is not irreversible. In male and female (when neces­sary) it is possible to join the severed vas deferens and fallopian tube to allow conception.

c. Laproscopy (in women):

In this method an instrument called laproscope is introduced through the abdomen with the help of a small cut near the naval. The instrument is taken into the fallopian tubes (it is possible to see the internal organs through the laproscope) and the tubes are tied or their lumen is sealed.

Laproscopy is a very simple and effective procedure when compared to tubectomy as it does not involve opening of the abdomen it can be done under local anesthesia and needs one hour of hospitalization and can be done any time. Usually laproscopy is done after the 5th day of menstrua­tion and not during the middle period of the cycle.

6. Pharmacological methods (hormone pills for women)

In this method, the hormone pills inhibit the secretion of hormones that help in maturation of ovum and ovulation. The hormonal pills have proges­terone and a little of estrogen. The pills (oral contraceptives) have to be taken every day starting from the 5th day of the menstrual cycle up to the 25th day of the cycle. The pillsa reproduction to be stopped on the 26th day when menstrual cycle is initiated and ovulation begins and menstrua­tion starts at the appointed date.

Oral contraceptive pills are of various types- combination pills, sequential pills, mini pills and morning after pills etc.

Side effects of oral contraceptives:

Since the pills interfere with the nor­mal hormone production in the body they have several side effects. Pro­longed use results in painful breasts, nausea, increased weight, increased sugar in the blood, vaginal bleeding etc. A relationship between the use of pill and blood clots (in legs, lungs etc) has been observed. Women above the age of 40 should not use pills.

Male contraceptive vaccine:

In this, an injection (Antiandrogen injec­tion) given to the male prohibits production of sperms for a long time. However this method is still under experimental stage. Researches on this are being carried out at the Indian Institute of Science Bangalore and re­sults are encouraging.

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